Connect with us

Canada News

Why Ontario had to transfer thousands of Toronto COVID-19 patients to other cities’ hospitals

Published

on

Why would Ontario need to transfer masses of critically ill patients with a highly infectious disease across the province, even resorting to involuntary transfers? Why would a metropolis like Toronto call on comparatively tiny Newfoundland for health-care workers? Is this simply the unavoidable consequences of a huge third wave of COVID-19? (File photo: camilo jimenez/Unsplash)

You can learn a lot from a crisis. During Ontario’s COVID-19 pandemic, over 2,500 patients have required transfer from Toronto to receive life-saving care in other cities.

The egress of COVID-19 patients from Toronto began in mid-November 2020, when the Ontario government activated the GTA Hospital Incident Management System. Transfers peaked in April during the third wave of COVID-19.

At Kingston Health Sciences Centre (KHSC) we have received over 100 Toronto area patients with COVID-19, many on ventilators. They came by helicopter, ambulance and even by bus, unaccompanied by family.

Ontario even put out a national call for health-care workers to help out, and Newfoundland answered.

https://twitter.com/Ornge/status/1385568019221565441

Why would Ontario need to transfer masses of critically ill patients with a highly infectious disease across the province, even resorting to involuntary transfers? Why would a metropolis like Toronto call on comparatively tiny Newfoundland for health-care workers? Is this simply the unavoidable consequences of a huge third wave of COVID-19?

In fact the root causes began long before the pandemic and originated with a flawed understanding of the capacity (physical and human) of our health-care system.

Two fallacies

I lead the department of medicine at Queen’s University and co-lead the medicine program at KHSC. In these roles I am responsible for hiring doctors and ensuring our medicine beds run efficiently. I have often been confronted by two fallacies relevant to the genesis of our current crisis:

  • Fallacy 1 — Ontario has enough hospital beds because medical care is largely conducted on an outpatient basis.
  • Fallacy 2 — Canada has more than enough health-care workers and doctors.

Both fallacies have been widely embraced by provincial and federal governments. Let’s examine the validity of these beliefs with the goal of designing a more resilient health-care system.

Fallacy 1: Number of hospital beds

It is popular in Canada to believe that the future of medicine is mostly in outpatient care and that hospital beds are obsolete. In reality, as medicine becomes more high-tech, admissions are shorter but more beds are needed to support procedures that improve the quality and duration of life.

We are now putting heart valves, hips, lenses and more into older Canadians, and performing lifesaving diagnostic and therapeutic interventions on people who 20 years ago would have been considered ineligible because they were too premature, too obese or too high-risk.

Canada’s bed shortage is particularly critical in academic health sciences centres that uniquely deliver advanced forms of care. Pre-pandemic Ontario was running at 96 per cent occupancy.

Our bed capacity was designed for troughs in demand, like summer, not for peaks, as occur each fall when influenza strikes. Every fall, as rates of infections like influenza rise, our emergency departments and medicine wards become congested and admitted patients must be accommodated in hallways. These are the consequences of inadequate numbers of in-patient beds. The COVID-19 pandemic simply made our tenuous reserve capacity more apparent.


Read more: Why we need academic health science centres


Ontario has built new bed capacity for COVID-19, but had minimal reserve capacity pre-pandemic.

Ontario Health did three things to deal with COVID-19:

  1. Relocated 1,000 people from hospitals, including alternative level of care patients;

  2. Cancelled “elective procedures” and repurposed the resulting 6,849 beds for possible COVID-19 patients (necessary but dangerous to the health of the 99 per cent of Canadians that don’t have COVID-19; and

  3. Opened 2,500 new hospital beds.

The government views Ontario’s health-care system as “one resource.” That sounds good in principle, but moving patients on ventilators away from their families is a poor way to deliver care. In addition, most of Ontario’s COVID-19 capacity derives from deferring elective procedures, few of which are truly elective.

The simple truth is we were never configured to deal with surges in admissions. We mistakenly focused on the symptoms of bed deficiency, like “hallway medicine” and emergency room wait times and failed to address the root cause: inadequate numbers of beds (in hospitals and long-term care facilities).

Several caveats about this bed-centric article are relevant. First, outpatient care is important and when it fails, unnecessary hospitalizations occur.

Second, inadequate long-term care facilities and home care services in the community exacerbate the bed shortage by causing inappropriate hospitalization of people awaiting alternate levels of care.

Third, don’t let the term “hospital bed shortage” mislead you to envision a shortage of mattresses and pillows; a “bed” is a surrogate for the capital and human resources required to provide care in that bed 24/7, 365 days a year.

Fallacy 2: Number of health-care workers

Canada has 86,092 active physicians (excluding trainees), 25 per cent of whom are international medical graduates. When recruiting academic physicians, I often struggle to find a Canadian-trained doctor and rely on our pool of international medical graduates. These doctors are often first-rate, but the fact we rely on other countries to train our doctors is not widely recognized.

Our dependence on international medical graduates does not reflect Canadians not wanting to become doctors. Queen’s University School of Medicine has 5,000 applicants for 100 seats and more Canadians are training abroad as physicians than in Canada. The Organization for Economic Co-operation and Development (OECD) tracks medical graduates per 100,000 inhabitants in member countries. Canada is near the bottom.

Our physician-to-population ratio is also low, ranking 29 out of 36 OECD nations. The reality is that doctors and other health-care workers are expensive. Canada’s universal health-care system has many advantages; however, a single-payer system means the provincial governments (the payers) see a whopping human resources bill every year and, in trying to control costs, are invested in keeping numbers of physicians (and hospital beds) in check.

COVID-19 has given us a master class in what is wrong with our health-care system. Admittedly, Canada’s post-pandemic to-do list is long and includes improving the care of seniors, providing affordable child care, fostering a domestic biotech industry, re-establishing a pandemic surveillance system and bolstering public health programs. We also need to legislate good employment practices, such as provision of paid sick days.

Additionally, we need to continue the funding for the new beds created to deal with the pandemic, using them flexibly to ensure we have surge capacity. We should also create an adequate supply of domestically trained health-care professionals.

It is clear what must be done. We must find the funds and will power to meet the post-pandemic moment with action.The Conversation

Stephen L Archer, Professor, Head of Department of Medicine, Queen’s University, Ontario

This article is republished from The Conversation under a Creative Commons license. Read the original article.

xosotin chelseathông tin chuyển nhượngcâu lạc bộ bóng đá arsenalbóng đá atalantabundesligacầu thủ haalandUEFAevertonxosofutebol ao vivofutemaxmulticanaisonbethttps://bsport.fithttps://onbet88.ooohttps://i9bet.bizhttps://hi88.ooohttps://okvip.athttps://f8bet.athttps://fb88.cashhttps://vn88.cashhttps://shbet.atbóng đá world cupbóng đá inter milantin juventusbenzemala ligaclb leicester cityMUman citymessi lionelsalahnapolineymarpsgronaldoserie atottenhamvalenciaAS ROMALeverkusenac milanmbappenapolinewcastleaston villaliverpoolfa cupreal madridpremier leagueAjaxbao bong da247EPLbarcelonabournemouthaff cupasean footballbên lề sân cỏbáo bóng đá mớibóng đá cúp thế giớitin bóng đá ViệtUEFAbáo bóng đá việt namHuyền thoại bóng đágiải ngoại hạng anhSeagametap chi bong da the gioitin bong da lutrận đấu hôm nayviệt nam bóng đátin nong bong daBóng đá nữthể thao 7m24h bóng đábóng đá hôm naythe thao ngoai hang anhtin nhanh bóng đáphòng thay đồ bóng đábóng đá phủikèo nhà cái onbetbóng đá lu 2thông tin phòng thay đồthe thao vuaapp đánh lô đềdudoanxosoxổ số giải đặc biệthôm nay xổ sốkèo đẹp hôm nayketquaxosokq xskqxsmnsoi cầu ba miềnsoi cau thong kesxkt hôm naythế giới xổ sốxổ số 24hxo.soxoso3mienxo so ba mienxoso dac bietxosodientoanxổ số dự đoánvé số chiều xổxoso ket quaxosokienthietxoso kq hôm nayxoso ktxổ số megaxổ số mới nhất hôm nayxoso truc tiepxoso ViệtSX3MIENxs dự đoánxs mien bac hom nayxs miên namxsmientrungxsmn thu 7con số may mắn hôm nayKQXS 3 miền Bắc Trung Nam Nhanhdự đoán xổ số 3 miềndò vé sốdu doan xo so hom nayket qua xo xoket qua xo so.vntrúng thưởng xo sokq xoso trực tiếpket qua xskqxs 247số miền nams0x0 mienbacxosobamien hôm naysố đẹp hôm naysố đẹp trực tuyếnnuôi số đẹpxo so hom quaxoso ketquaxstruc tiep hom nayxổ số kiến thiết trực tiếpxổ số kq hôm nayso xo kq trực tuyenkết quả xổ số miền bắc trực tiếpxo so miền namxổ số miền nam trực tiếptrực tiếp xổ số hôm nayket wa xsKQ XOSOxoso onlinexo so truc tiep hom nayxsttso mien bac trong ngàyKQXS3Msố so mien bacdu doan xo so onlinedu doan cau loxổ số kenokqxs vnKQXOSOKQXS hôm naytrực tiếp kết quả xổ số ba miềncap lo dep nhat hom naysoi cầu chuẩn hôm nayso ket qua xo soXem kết quả xổ số nhanh nhấtSX3MIENXSMB chủ nhậtKQXSMNkết quả mở giải trực tuyếnGiờ vàng chốt số OnlineĐánh Đề Con Gìdò số miền namdò vé số hôm nayso mo so debach thủ lô đẹp nhất hôm naycầu đề hôm naykết quả xổ số kiến thiết toàn quốccau dep 88xsmb rong bach kimket qua xs 2023dự đoán xổ số hàng ngàyBạch thủ đề miền BắcSoi Cầu MB thần tàisoi cau vip 247soi cầu tốtsoi cầu miễn phísoi cau mb vipxsmb hom nayxs vietlottxsmn hôm naycầu lô đẹpthống kê lô kép xổ số miền Bắcquay thử xsmnxổ số thần tàiQuay thử XSMTxổ số chiều nayxo so mien nam hom nayweb đánh lô đề trực tuyến uy tínKQXS hôm nayxsmb ngày hôm nayXSMT chủ nhậtxổ số Power 6/55KQXS A trúng roycao thủ chốt sốbảng xổ số đặc biệtsoi cầu 247 vipsoi cầu wap 666Soi cầu miễn phí 888 VIPSoi Cau Chuan MBđộc thủ desố miền bắcthần tài cho sốKết quả xổ số thần tàiXem trực tiếp xổ sốXIN SỐ THẦN TÀI THỔ ĐỊACầu lô số đẹplô đẹp vip 24hsoi cầu miễn phí 888xổ số kiến thiết chiều nayXSMN thứ 7 hàng tuầnKết quả Xổ số Hồ Chí Minhnhà cái xổ số Việt NamXổ Số Đại PhátXổ số mới nhất Hôm Nayso xo mb hom nayxxmb88quay thu mbXo so Minh ChinhXS Minh Ngọc trực tiếp hôm nayXSMN 88XSTDxs than taixổ số UY TIN NHẤTxs vietlott 88SOI CẦU SIÊU CHUẨNSoiCauVietlô đẹp hôm nay vipket qua so xo hom naykqxsmb 30 ngàydự đoán xổ số 3 miềnSoi cầu 3 càng chuẩn xácbạch thủ lônuoi lo chuanbắt lô chuẩn theo ngàykq xo-solô 3 càngnuôi lô đề siêu vipcầu Lô Xiên XSMBđề về bao nhiêuSoi cầu x3xổ số kiến thiết ngày hôm nayquay thử xsmttruc tiep kết quả sxmntrực tiếp miền bắckết quả xổ số chấm vnbảng xs đặc biệt năm 2023soi cau xsmbxổ số hà nội hôm naysxmtxsmt hôm nayxs truc tiep mbketqua xo so onlinekqxs onlinexo số hôm nayXS3MTin xs hôm nayxsmn thu2XSMN hom nayxổ số miền bắc trực tiếp hôm naySO XOxsmbsxmn hôm nay188betlink188 xo sosoi cầu vip 88lô tô việtsoi lô việtXS247xs ba miềnchốt lô đẹp nhất hôm naychốt số xsmbCHƠI LÔ TÔsoi cau mn hom naychốt lô chuẩndu doan sxmtdự đoán xổ số onlinerồng bạch kim chốt 3 càng miễn phí hôm naythống kê lô gan miền bắcdàn đề lôCầu Kèo Đặc Biệtchốt cầu may mắnkết quả xổ số miền bắc hômSoi cầu vàng 777thẻ bài onlinedu doan mn 888soi cầu miền nam vipsoi cầu mt vipdàn de hôm nay7 cao thủ chốt sốsoi cau mien phi 7777 cao thủ chốt số nức tiếng3 càng miền bắcrồng bạch kim 777dàn de bất bạion newsddxsmn188betw88w88789bettf88sin88suvipsunwintf88five8812betsv88vn88Top 10 nhà cái uy tínsky88iwinlucky88nhacaisin88oxbetm88vn88w88789betiwinf8betrio66rio66lucky88oxbetvn88188bet789betMay-88five88one88sin88bk88xbetoxbetMU88188BETSV88RIO66ONBET88188betM88M88SV88Jun-68Jun-88one88iwinv9betw388OXBETw388w388onbetonbetonbetonbet88onbet88onbet88onbet88onbetonbetonbetonbetqh88mu88Nhà cái uy tínpog79vp777vp777vipbetvipbetuk88uk88typhu88typhu88tk88tk88sm66sm66me88me888live8live8livesm66me88win798livesm66me88win79pog79pog79vp777vp777uk88uk88tk88tk88luck8luck8kingbet86kingbet86k188k188hr99hr99123b8xbetvnvipbetsv66zbettaisunwin-vntyphu88vn138vwinvwinvi68ee881xbetrio66zbetvn138i9betvipfi88clubcf68onbet88ee88typhu88onbetonbetkhuyenmai12bet-moblie12betmoblietaimienphi247vi68clupcf68clupvipbeti9betqh88onb123onbefsoi cầunổ hũbắn cáđá gàđá gàgame bàicasinosoi cầuxóc đĩagame bàigiải mã giấc mơbầu cuaslot gamecasinonổ hủdàn đềBắn cácasinodàn đềnổ hũtài xỉuslot gamecasinobắn cáđá gàgame bàithể thaogame bàisoi cầukqsssoi cầucờ tướngbắn cágame bàixóc đĩaAG百家乐AG百家乐AG真人AG真人爱游戏华体会华体会im体育kok体育开云体育开云体育开云体育乐鱼体育乐鱼体育欧宝体育ob体育亚博体育亚博体育亚博体育亚博体育亚博体育亚博体育开云体育开云体育棋牌棋牌沙巴体育买球平台新葡京娱乐开云体育mu88qh88
Continue Reading
Click to comment

Leave a Reply

Your email address will not be published. Required fields are marked *

Maria in Vancouver

Lifestyle1 day ago

How To Do Christmas & Hanukkah This Year

Christmas 2024 is literally just around the corner! Here in Vancouver, we just finished celebrating Taylor Swift’s last leg of...

Lifestyle4 weeks ago

Nobody Wants This…IRL (In Real Life)

Just like everyone else who’s binged on Netflix series, “Nobody Wants This” — a romcom about a newly single rabbi...

Lifestyle1 month ago

Family Estrangement: Why It’s Okay

Family estrangement is the absence of a previously long-standing relationship between family members via emotional or physical distancing to the...

Lifestyle3 months ago

Becoming Your Best Version

By Matter Laurel-Zalko As a woman, I’m constantly evolving. I’m constantly changing towards my better version each year. Actually, I’m...

Lifestyle3 months ago

The True Power of Manifestation

I truly believe in the power of our imagination and that what we believe in our lives is an actual...

Maria in Vancouver4 months ago

DECORATE YOUR HOME 101

By Matte Laurel-Zalko Our home interiors are an insight into our brains and our hearts. It is our own collaboration...

Maria in Vancouver4 months ago

Guide to Planning a Wedding in 2 Months

By Matte Laurel-Zalko Are you recently engaged and find yourself in a bit of a pickle because you and your...

Maria in Vancouver5 months ago

Staying Cool and Stylish this Summer

By Matte Laurel-Zalko I couldn’t agree more when the great late Ella Fitzgerald sang “Summertime and the livin’ is easy.”...

Maria in Vancouver5 months ago

Ageing Gratefully and Joyfully

My 56th trip around the sun is just around the corner! Whew. Wow. Admittedly, I used to be afraid of...

Maria in Vancouver6 months ago

My Love Affair With Pearls

On March 18, 2023, my article, The Power of Pearls was published. In that article, I wrote about the history...